Secondary Prevention of Schizophrenia. A randomized controlled trial

• Applicant: Professor Dr. Joachim Klosterkötter
• Subject Area: Clinical Psychiatry, Psychotherapy, Child and Adolescent Psychiatry
• Term: from 2007 to 2010
• Project identifier: Deutsche Forschungsgemeinschaft (DFG) - Project number 34815856

Schizophrenia is a chronic disease with devastating consequences for individuals, families and society. In recent years, new clinical findings and hypotheses suggested that secondary prevention of schizophrenia (SPS) may be possible. Although atypical neuroleptics (AN) and cognitive-behavioral therapy (CBT) have been used in secondary prevention efforts, due to methodological limitations the preventive effects remains uncertain and the differential efficacy of CBT and AN for persons at risk of being prodromally symptomatic for psychosis (PAR) is unknown. Therefore PREVENT addresses the following principal research questions with high methodological rigor: (1) Are clinical management and aripiprazole combined (CM+ARI) more effective in persons at risk of being prodromally symptomatic for psychosis (PAR) than CM and placebo combined (CM+PL)? (2) Is cognitive-behavioral therapy (CBT) more effective in PAR than CM+PL? (3) Is CBT not less effective in PAR than CM+ARI? At 7 early detection and intervention centers 380 PAR will be recruited over a 30-months period in a 12-months parallel group randomized controlled trial with three study conditions [CM+ ARI, CM+PL (double-blind), CBT (blinded ratings)]. Positive PREVENT results with regard to the primary aim of SPS “prevention/delay of transition to psychosis” will justify SPS as a standard practice in mental health care. Moreover, they will suggest that CBT is comparable effective to AN. Thus PAR will benefit from a choice of prevention strategies. Thereby acceptance, tolerance and compliance with SPS efforts in PAR, in their families and in the general population is likely to improve and the impact of the mental health system on burden, disability and economical consequences of schizophrenia might be strengthened.

• DFG Programme: Clinical Trials
• Participating Persons: Professor Dr. Andreas Bechdolf; Professor Dr. Peter Falkai; Professor Dr. Wolfgang Gaebel; Professor Dr. Andreas Heinz; Professor Dr. Wolfgang Maier; Professor Dr. Hans-Jürgen Möller; Professor Dr. Frank Schneider; Professor Michael Wagner, Ph.D.